Transfusion-associated circulatory overload

Adverse events related to transfusion of blood components have been reported, including febrile non-hemolytic transfusion reactions, mild febrile reactions, acute and delayed hemolytic transfusion reactions, transfusion-related acute lung injury (TRALl), anaphylactic and other allergic reactions, graft-versus-host disease (GvHD), transfusion-associated circulatory overload (TACO), viral infections, post-transfusion bacteremia, transfusion-associated sepsis (TAS), hemosiderosis, post-transfusion purpura, and new allo-antibody formation [18 , 19 ]. Whole blood, erythrocytes, leukocytes, platelets, and plasma for transfusion (fresh frozen plasma, FFP) are involved. Quite a number of these adverse effects, such as TRALl, TACO, TAS, and allergic/anaphylactic reactions can be difficult to evaluate. 

Observational studies In a study of 30 patients who received pooled, whole blood-derived granulocytes in additive solution and plasma, authors report one transfusion-associated circulatory overload and three patients developed new leucocyte alloimmunisation [23 ]. 

Systematic reviews Plasma transfusion is closely associated with risks such as TRALl, transfusion-associated circulatory overload and allergic spectrum reactions. These and other risks are nicely reviewed by Pandey and Vyas [39 ]. 

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